Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 824 | OK |
Y | 1041C0700X | Clinical Social Worker | 4466 | OK |
NPI | 1003058959 |
---|---|
Provider Name | Mr. Joe Mcelhaney JR. |
First Address | Moore, OK 73160-3612 |
Second Address | Moore, OK 73160-3612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2009 |
Last Update Date | 15/06/2021 |